How to find a new primary care provider (PCP)?

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Related to two other threads:

Our current provider is leaving and remaining physicians in their practice cannot absorb any affected patients.

Step one: Ask everyone for a recommendation. So far, not one of their MD’s are taking new patients. Although I live near a medium sized city, with multiple hospitals and several competing health groups, there are simply not enough generalists. A few new MD’s are available (newly licensed, new to town, therefore unfamiliar with the hospitals and specialists), or sadly a few complaints creating concern. Most have little information posted other than medical school attended. Nurse practitioners are an alternative although also scarce. NP’s, especially with experience are often incredible resources. I’m just unfamiliar with that option.

Question 1: Are there any substantial downsides to working only with a nurse practitioner as a PCP?

Step two: Consider “ratings”. Hospitals have outcomes, and readmission rates. I have seen nothing similar for doctors, NP’s or groups. There are rating websites (Healthgrades, WebMD, Vitals, etc. ), but comments if any, are few and often meaningless. I care less about wait times, or an occasional billing error. I care a lot about thoroughness, knowledge, communication, capacity for referrals, outcomes, and most of all, the ability to diagnose.

Question 2: What better resources are available to compare specific practitioners or their offices?

Step three: Interview one or two, if even possible. I would never consider hiring most professionals, without an initial consultation to see if we’re a good match. PCPs are so overwhelmed they don’t need extra business. They have something called an “establishing care” visit, but that is assuming you’ve already made your choice as well as an appointment.

Questions 3+: What is the accepted method to try a new unknown practice? Just pick one and hope for the best? If you try a new MD, and are not completely comfortable, does insurance even allow another visit elsewhere?

It has been so long since needed, and the medical and insurance fields have completely changed over that time. Most questions above center on the hope of finding a personal physician that we can develop a relationship over time, whom we can rely on for referrals and direction when needed.

Question 4: Is this simply “old school” thinking, and if not going concierge, we’re all moving toward drop-in clinics?

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Personally, I have had great experiences with Nurse Practitioners. I would not have a concern having one as my PCP.

I think you need to take into consideration your insurance and when and why you go to your PCP. For me, for an urgent matter (like a UTI, or flu, etc), I usually hit the very large local urgent care (not my PCP). My insurance allows me to see a specialist without a recommendation, so I don’t see her for something like a skin condition, etc. I basically only see my PCP for my biannual checkups. I just had one this month. Although I really like my PCP, all she does is compare my bloodwork against prior years, ask basic questions, hand me my script for my regular mamo, and we are done. I selected her because she is part of a big local practice with all the specialists and the urgent care and the outpatient surgery I already use , and a friend recommended her.

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Go on insurance website. Login and do search for primary care providers who are taking new patients in your area.

If provider = MD or DO, then go on state medical board website to look up where they went to med school, where they did residency, + confirm if they have any malpractice judgements against them.

Then pick 1 and make new patient appt w/them.

You should expect that if you want to interview them, that they will bill your insurance for an appointment. So you’ll have to basically pay for that.

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We see the PA a local GP, there is also a NP, both are highly recommended by locals (so is the GP but it’s hard to get an appointment with him, I’ve never met him). The PA is SO thorough, my 20 just went yesterday for a checkup and came home with 3 referrals (and she will call to follow up on them).

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Two sites I used with mostly good results are the Nextdoor and Reddit forums for our community. City-Data was somewhat useful, although the forum for our current area does not allow any negative comments about businesses so you have to request direct messages if someone has a complaint.

I first checked our insurance company’s site to see who are the participating providers, then searched for reviews (Google, Healthgrades, etc.) on the ones who are most convenient. You may want to screen by hospital, too.

Someone posted here a while back about seeing an internist instead of a GP and I may look into that as we’re not very happy with our current PCP. Depending on your situation, an internist might work for you, too.

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One of my favorite providers was an NP. I would not hesitate for a minute going to one for primary care if you get a personal recommendation.

I worked in health care for my early career and always felt like I had “insider information” for choosing practitioners. The one time that I needed a referral the most was when I wasn’t working and had moved to a different state. I called the nurses’ station at the best hospital in the area, in the speciality that I needed, and ask them who they recommended. They said they weren’t able to give that out but when nudged a bit, they gave me a list. As it turned out, it was every doctor in one specific practice.

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At least with larger medical groups, PCPs may write short blurbs about their medical and other interests, so if you find one with medical interests that are particularly relevant for you but are not the usual common ones that all PCPs encounter all the time (high cholesterol, high blood pressure, recommended screenings, diet and exercise, …), that may be a point in favor of that PCP.

(One thing I did notice about the blurbs is that there appeared to be some correlation of a PCP’s medical interests to the PCP’s race or ethnicity, in that medical conditions or risks more common to a race or ethnicity were more commonly mentioned by PCPs of that race or ethnicity.)

However, that may not help if there is an extreme shortage of PCPs accepting new patients in your area, in which you may have to take whoever is available.

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Sadly, I think it is. If someone is unfortunate enough to need to be hospitalized, the days where your own doctor who knows you and your medical history taking charge of your care are (for most of us) long gone. Instead you’ll probably be treated by and making the most important decisions of your life with a “hospitalist”, a doctor that only works in the hospital and whom you’ve never met before. I just hope I’m at least conscious when my turn comes.

So for routine medical care the doc-in-the-box is probably the future. In the nearer term while you can still pick a doctor who you see while still relatively healthy then I’d suggest looking a where they did their residency. Slots at top-ranked hospitals are hard to get and so it may be an indication of quality, although one can never know if they fulfilled all the expectations or barely squeaked by.

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The physician’s specialty and residency would be indicators of how well they did in medical school. But would that necessarily correlate to how well they explain things to patients, how well they handle patient-specific issues, etc.?

Also, even if you knew how well they did in residency, does sleep-deprived performance necessary correlate well to performance without sleep deprivation?

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My PCP is an internist, but as long-timers here may recall, I have MANY significant medical issues. I found my primary through a referral by my therapist. Doc wasn’t originally in a concierge, but switched to one as a way to ease into a less-crazy as he got into his 60s. (As concierge practices go, his fee is VERY low.) Because of all my issues, I need a doc who can coordinate everything and who gets the big picture. My PCP was also able to educate the hospitalist on my background when I was in the ICU after my cardiac arrest. He had a NP who was extraordinary, but she left when he went concierge. My experience is that NPs do a terrific job at taking medical histories and asking really relevant questions. I’ve had a couple over the years who flagged serious issues before they became critical.

Found our pediatrician through the preschool my sons attended – and I had no idea til H read the bios, but the doc was a friend of H’s from Bronx Science and they were both on debate team together!

As for recommendations? I ask my primary, I ask folks I know who have had similar procedures (esp orthopedics – half my synagogue sees a particular practice and PT facility). Once I’m seeing a PT for one thing, I ask for recommendations for other body parts (i.e., hand OTs). I found my oncologist via an online group for my kind of leukemia. Have been seeing her for 20 years now. She says her relationship with me has lasted longer than her marriage! I need to find a new GYN – mine retired, and I’ve seen her since S2 was born.

My primary also gives me recommendations, but I have not liked several of them. Too much ego and old boys’ network among them, and a couple times they made serious misdiagnoses. When my cardiologist left and moved to western MD, I went through four docs before finding one I liked and who understood my complicated history. I got recommendations, but they just weren’t good fits.

I also check backgrounds and education to the extent possible, but top schools aren’t dispositive for me.

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I’ve asked for referrals from friends and relatives as well as my specialists. I got my newer lung docs —one from another lung doc who was retiring and one from an allergist who was also retiring. When my internist was having his own health challenges, I asked my new lung doc for a referral to a good internist he worked well with, so they can be in same EMS system. He referred me to the internist who provides his care and I like her a lot.

My H was referred to a new internist when his old one retired and has been satisfied with her.

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To be honest, finding a new primary care MD can be very challenging. Our neighbors switched from PPO to HMO be use their MDs kept retiring or moving and they got exhausting finding new ones. With the HMO, they just accept the MDs at the HMO.

Your insurer should have a list of participating and preferred primary care doctors—that could be a useful place to start. I like having a primary care doc that can catch things that urgent care may miss, since urgent care doesn’t know me and my history as well as someone who has been treating me awhile.

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Unless you have a common cold or pink eye stay away from most urgent cares. Lots of misdiagnosis. If you have any Many are staffed by NP in my area

I would be wary of NP and PA as my primary source provider but can be great as an adjunct to your care.

I tend to find an internist. I used to just go to a cardiologist that also did internal medicine. My really good young cardiologist wants me to have /get one but all they did in the past was treat the same cholesterol /high blood pressure issues that I am seeing him for but he feels it’s important so they can evaluate other issues and he just gave me 3 names of people to look into.

I have had luck also going through my hospitals web page and picking someone. I like the hospital system overall and guess sometimes just get lucky.

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I look at websites for practices (including hospital systems) for providers: family medicine and especialy internal medicine.

I read the info on physicians, including their clinical interests (more relevant for specialists), where they went to school etc., though a Harvard doc might not be chosen over a state U doc actually.

I note awards like “compassionate doc,” or top doc in a magazine, though again, that is just one factor and some top docs aren’t actually as good with patients as with peers.

The most helpful thing for me is reviews (and ratings) on Vitals and Health Grades etc. but I read them all, because some ratings are due to office staff. Lengthy reviews that are full of praise can really sway me.

I have waited a year for a PCP. I have seen a fellow training in the practice while I wait. All kinds of scenarios. It is rare to get in with a doc that we choose, at least at first.

Now that I am on a PPO Medicare Advantage Plan, I barely use my PCP. If I do go to the office I see the NP with whom I have a relationship. For any future searches I would make sure I like the PCP.

Choice of docs is crucial, unfortunately. I had a cardiologist who wanted me on blood thinners 7 years ago for afib that happened (albeit dramatically) once a year. Now it hasn’t happened in two years. I found another cardiologist who told me to pretend these episodes never happened. I got 4 opinions on my cancer and finally found the right path with the 4th. Scary.

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Blood cholesterol issues and high blood pressure are so common that every PCP for adults deals with a lot of it. But your cardiologist is correct that a PCP (internal / family) is supposed to help you monitor other aspects of your health that a cardiologist may not pay as much attention to.

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I would then just rather go to a specialist. I am also a doctor so that is part of the problem :joy:

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Perhaps residency but defiitely not specialty. Are you assuming all PCPs rank at the bottom of their class?

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We do have an orthopedic urgent care that we have been to a few times over the years. It is the entry point if you want access to our state’s best orthopedic surgeons.

I and D have both been to urgent cares (different times). It is good for testing if you may have the flu etc but it is pretty exhausting trying to share your medical history if it’s complicated and I didn’t want to go but was ill and my MD was unable to fit me in as usual. I was pretty ill. Never want to see that internist again—she asked tons of Qs but gave me very little answers or suggestions. I left exhausted and frustrated. D was happy as testing revealed she didn’t have flu, strep throat, etc. Her visit was much shorter and to the point than my prolonged visit.

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I have a Medicare Advantage plan. I can change PCPs as many times as I want, so I would do that if I wanted to see a new PCP to check them out.

I agree with those who say to look at local networks–local family and friends of course, and FB and all the local sites. Also if you google the doctor, the chances are that there will be reviews on booking sites such as ZocDoc. Just keep in mind that people are much more likely to post negative experiences. If you see local specialists, it may be helpful to ask their office staff.

Good luck! I love my PCP and I have recommended her many times on various networks and email lists I am on. Now if you lived in Brooklyn…

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I guess I am very fortunate that the nearest urgent care is part of the medical facility where my family has our PCPs and all our specialists. They are also an outpatient surgery center (got our colonoscopies there). So, it is one stop shopping, the urgent care has access to all your medical records, they have access to lots of equipment on site (Xray, MRIs, etc.) and specialists in the same building to send you to. I do understand this is not always the case, many urgent care facilities are only good for simple stuff like giving you a strep test.

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